Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia.

BACKGROUND: Toxoplasmosis, a zoonotic disease distributed worldwide, is an infection caused by the ubiquitous obligatory intracellular coccidian protozoan organism, Toxoplasma gondii. It is a major public health concern because the disease is serious in terms of mortality or physical and /or psychological sequellae in patients with HIV disease. The aim of the study was to assess the seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in HIV infected and non-infected individuals attending Felege Hiwot referral hospital, Bahir Dar, Northwest Ethiopia. METHODS: A cross sectional study was conducted at Felege Hiwot referral hospital, Bahir Dar, Amhara National Regional State. Venous blood samples were collected from 103 HIV infected pre anti-retroviral therapy patients at Felege Hiwot referral hospital and 101 HIV negative apparently healthy voluntary blood donors at the blood bank. Serum samples were analyzed for anti-Toxoplasma gondii IgG and IgM antibodies using a commercially available ELISA kit. Socio-demographic and associated risk factors for Toxoplasmosis from each individual were also obtained and the data was analyzed using SPSS version 18. RESULTS: Of the examined HIV seropositive individuals, 87.4% (90/103) and 10.7% (11/103) were positive for anti-T. gondii IgG and IgM antibodies, respectively. Multivariate analysis using logistic regression showed that anti-T. gondii seropositivity was independently significantly associated with undercooked or raw meat consumption (adjusted OR=5.73, 95% CI=1.35-24.39; P=0.02) and having contact with cat (adjusted OR= 4.29, 95% CI=1.08-16.94; P=0.04) in HIV positive individuals. In HIV negative apparently healthy blood donors, prevalence of anti-T. gondii antibodies were 70.29% and 2.97% for IgG and IgM, respectively. Multivariate analysis showed that undercooked or raw meat consumption (adjusted OR=6.45, 95% CI=2.16-19.28; p=0.001) and sex (OR=6.79, 95% CI=2.14-21.60; p=0.001) were independently significantly associated with anti-T. gondii IgG seropositivity, with a significantly higher number of males affected than females. CONCLUSION: The present findings showed a high sero-prevalence of anti-T. gondii antibodies in HIV infected pre-ART and HIV non-infected apparently healthy blood donors in Bahir Dar. Consumption of undercooked or raw meat might greatly contribute towards acquiring T. gondii infection in HIV infected pre-ART and HIV non-infected apparently healthy blood donors. It may be appropriate to include routine serological screening test for determination of anti-T. gondii antibodies in HIV infected pre-ART individuals and HIV negative apparently healthy blood donors. In addition, health education towards avoiding eating undercooked and raw meat, and avoiding contact with cats were recommended.

ART-naive HIV patients at Feleg-Hiwot referral hospital Northwest, Ethiopia

Objectives:To determine socio-demographic and immunological status of anti-retroviral treatment (ART)-naive HIVpositive patients. Methods: This was a longitudinal survey of HIV-positive patients treated with ART at Felege-Hiwot Hospital. CD4 cell counts were enumerated at baseline and after 6 months of treatment using FACS count (Becton Dickinson). Socioeconomic data were collected using pre tested questionnaires. Results: Three hundred sixty eight (62female); with median age 30 years were enrolled. Of these; 207 (56.5) were uneducated and 233 (66.8) had monthly income ? 250 birr. Three hundred fifteen (85.6) started ART within 6 months of HIV diagnosis. The mean (95CI) CD4 cell count at baseline was 153 (139-167); 156 (137-175) for females and 122 cells/?l (105-139) for males (p0.01). At baseline; 280 (76.3) and 134 (36.4) patients had CD4 cell count 200 and ? 100 cells/?l; respectively. Six months follow-up CD4 counts were enumerated for 225 (61) patients and their mean CD4 cells increased from 143-261 cells/?l (p 0.05) with a mean cell gain of 117 cells/?l. Of the 166 follow-up patients withCD4 count 200 cells/?l at baseline; 130 (78) attained a higher CD4 cells count after treatment compared to 50 (85.6) of the 59 with CD4 cell 200 cells/?l (p=0.21). conclusion: In this setting; HIV patients started ART with lower mean CD4 cell counts of 153 cells/?l and most patients with low baseline CD4 cells (200 cells/?l) counts didn't achieve an increase in the number of CD4 cells after treatment. The majority of ART-naive HIV patients were from low levels of education and with minimum monthly income. Appropriate interventions should be implemented to promote and enable HIV positive individuals to enter into ART programs as early as possible [Ethiop. J. Health Dev 2010;24(1):3-8]

Evaluation of Determine HIV-1/2 rapid diagnostic test by 4th generation ELISA using blood donors' serum at Felege Hiwot Referral Hospital, northwest Ethiopia.

OBJECTIVE: The study aims to evaluate the HIV-1/2 rapid diagnostic test kit is routinely used to screen HIV infection for safe blood transfusion and VCT services in many parts of Ethiopia. METHODS: A total of 324 sera were collected from consecutive blood donors from February to May 2006. All samples were screened for HIV infection using Determine HIV-1/2 (Abbott Japan) at hospital blood bank laboratory. Blindly, all serums were retested at Regional Health Research Laboratory using 4th generation ELISA (Vironostika HIV Uni-Form II AG/Ab) and Determine HIV-1/2 (Abbott lab). Discordant samples were repeatedly retested using the same ELISA and Determine HIV-1/2 to avoid technical errors. Finally, discordant results were resolved using Western Blot at the National HIV/AIDS Laboratory. RESULTS: Determine HIV-1/2 and ELISA showed 94.4% concordance in HIV antibody testing with fair Cohen's Kappa statistic value (0.68) among blood donors. The sensitivity, specificity, positive and negative predictive values of Determine HIV-1/2 were 60.5%, 98.9%, 88.5% and 94.9% respectively. CONCLUSION: As a rapid HIV screening test for blood donors, Determine HIV-1/2 showed poor sensitivity. Further evaluation at multiple centres is recommended to test its validity as a routine HIV screening test in blood donors. Use of a combination of rapid assays is also recommended for screening of HIV infection among the donor population.